A key way antibiotic-resistant infections are spread is by patients who move from one health care facility to another, according to new research, and public health officials believe one crucial way to combat the problem is through greater coordination among providers and local government.
The infections, such as MRSA and Clostridium difficile, known as C. diff, essentially hop rides with patients, even those who are not showing any symptoms, as they move between hospitals, nursing homes and other health care facilities, according to separate studies conducted by researchers at UC Irvine, Johns Hopkins University and the University of Utah.
The drug-resistant infections are even spread by patients who go home and are readmitted days or weeks later, the studies found.
Increased coordination between health care facilities and public health departments can play a crucial role in preventing the spread of antibiotic-resistant infections, according to the researchers. For example, facilities could set up special rooms for carriers, increase screenings for certain bacteria and maximize environmental cleaning.
"People who carry antibiotic resistance carry it for weeks or months," said Dr. Susan Huang, director of epidemiology and infection prevention at UCI Medical Center and the School of Medicine and a lead researcher of the UCI study. "We are dealing with a silent, invisible beast and we are going to need all hands on deck."
After reviewing the data, the Centers for Disease Control and Prevention is seeking federal funds to implement coordination programs across the country that would involve public health departments and private health care providers in efforts to identify outbreaks sooner, improve lab testing and track antibiotic resistance.
"Lack of coordination puts patients at higher risk," said CDC Director Dr. Thomas Frieden. "A coordinated approach where facilities work together and let each other know about drug resistant issues shows far fewer patients at risk."
CDC reports show that antibiotic resistance causes more than 2 million infections and at least 23,000 deaths each year. CDC officials said a more cohesive plan could prevent more than 600,000 infections and 37,000 deaths within five years. Frieden said making these changes would save $7.7 billion in spending associated with treating those infections.
Huang said the federally-funded UCI studies created a mathematical model that included years of patient data about antibiotic resistant infections from all of the nursing homes, hospitals and long-term acute facilities in Orange County. From that model, researchers were able to deduce how infection rates might be impacted by various preventive and other coordination strategies.
A coordinated effort is already underway in Chicago, where a secure database has been created to allow hospitals and nursing homes to query whether a patient is a known carrier, according to the CDC. It is the first of its kind in the country and CDC officials are holding it up as a model for other regions.